SPECIAL SESSION: SUICIDE IN ROAD TRAFFIC

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1 SPECIAL SESSION: SUICIDE IN ROAD TRAFFIC Session Organizer: Swedish Transport Administration Kenneth Svensson, Special Adviser Traffic Safety , Gothenburg, Sweden Phone: kenneth.svensson@trafikverket.se

2 GENERAL DESCRIPTION During the period a total of 1456 persons were killed in Swedish road traffic, natural deaths excluded. 143 of these fatalities were classified as suicides. This means that 10 percent (143 of 1456) of the road traffic fatalities were suicides. This has been established by using a method for suicide and accident classification that has been developed by The Swedish Transport Administration, The Swedish Transport Agency and The National Board of Forensic Medicine. In September 2016 the Swedish government presented a new launch of the Vision Zero. The government stated that suicides in the traffic system is a problem that has to be addressed within the traffic safety work. Preventive measures in order to reduce all fatalities in road traffic, intentional or accidental, is in line with the Vision Zero. In Korea 4621 persons were killed in road crashes in How many of these fatalities that in fact were hidden suicides are somewhat uncertain. However Korea is the country with the highest suicide rate among members of the Organization for Economic Cooperation and Development (OECD). According to OECD statistic, 28.7 suicides per inhabitants occurred in This can be compared with 12.3 suicides per inhabitants in Sweden. A special session will discuss suicide in road traffic. Four speakers will present topics regarding suicide and suicide in road traffic in Korea and Sweden. The session will include information on how suicide in road traffic can be assessed and what can be done to prevent these fatalities. Each presentation should be 15 minutes followed by 3 minutes of question and answer. This will allow for a discussion at the end of the session that can be approximately 15 minutes. The titles of the presentations and a brief description are listed below. 1. THE OVERALL SUICIDE PROBLEM IN KOREA Jong-Woo Paik M.D., Ph.D. Professor Department of Psychiatry, Kyung Hee University college of medicine General Secretary, Korea Association for Suicide Prevention paikjw@khu.ac.kr A presentation of the overall suicide situation in Korea will be made by Jong-Woo Paik, professor of the department of neuropsychiatry in Kyung Hee University and General Secretary of Korea Association for Suicide Prevention. 2(6)

3 2. SUICIDE IN TRAFFIC IN KOREA INCLUDING CLASSIFICATION METHOD Mr. Seokmin Lee Statistics Korea, Vital statistics Division Government Complex Deajeon, 189 Cheongsa-ro, Seo-gu, Deajeon, 35208, Republic of Korea Statistics Korea has published an annual report on the cause of death statistics of the Korean population since Statistics Korea will give a talk on suicide in Korean traffic including classification method. For more information, see abstract: Suicide in Traffic in Korea including classification method on page 4 of this document. 3. SUICIDE AND ACCIDENT CLASSIFICATION METHOD USED IN SWEDEN Anna-Lena Andersson, PhD, Special Adviser Traffic Safety Swedish Transport Administration / Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Department of Orthopedics Swedish Transport Administration, Gothenburg, Sweden anna-lena.andersson@trafikverket.se Since 2010 Sweden has been presenting statistics on suicides in road traffic separately from that on fatalities caused by accidents. To undertake this, a method has been developed for classification of road traffic fatalities in order to determine if the fatality was caused by an accident or by a suicide. For more information, see abstract nr 180: Suicide and accident classification methodology. 4. ANALYSIS OF SUICIDES IN ROAD TRAFFIC IN SWEDEN Mr. Kenneth Svensson, Special Adviser Traffic Safety Swedish Transport Administration Swedish Transport Administration, , Gothenburg, Sweden kenneth.svensson@trafikverket.se Descriptive and comparative analyses between suicides and fatalities due to accidents have been carried out. The objective has been to find suitable measures in order to reduce the number of suicides in road traffic. For more information, see abstract nr 179: Analysis of suicides in road traffic in Sweden (6)

4 SUICIDE IN TRAFFIC IN KOREA INCLUDING CLASSIFICATION METHOD Mr. Seokmin Lee Statictics Korea/Vital statistics Division Government Complex Deajeon, 18 9 Cheongsa-ro, Seo-gu, Deajeon, 35208, Republic of Korea Phone: leon32@korea.kr 1. INTRODUCTION Statistics Korea has published an annual report on the cause of death statistics of the Korean population since These statistics are important because they can provide key information for national demographic and health care policies by identifying the numbers, causes, and geographical distribution of deaths. This article presents the recent trends and statistical indicators related to suicide in road traffic. 5. METHODS In order to make the cause of death statistics, Statistics Korea collects data from death certificates issued for deaths filed in local administration offices. When death occurs, family should submit the death report form with medical death certificate issued by physicians to local offices. In order to compare the data internationally, the underlying causes of death were classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision(icd- 10), as recommended by WHO, as well as the KCD-6 (Korean Standard Classification of Diseases and Causes of Death), which has been modified to fit circumstances in Korea. In the ICD-10 code, X81 and X82 code cover the suicide in road traffic. X81 X82 Intentional self-harm by jumping or lying before moving object Intentional self-harm by crashing of motor vehicle Includes: intentional collision with: Train Motor vehicle Streetcar, tram However, it is possible that some death certificates are incorrectly written, especially external cause of death. In order to classify underlying cause of death more accurately, Statistics Korea collects and links the following 22 kinds of administrative data; health insurance data from National Health Insurance Service; criminal investigation records and traffic accident investigation data from National Police Agency; autopsy records from National Forensic Service; emergency records from National Emergency Medical Center, etc. In regard to analyzing suicide in road traffic, medical death certificate as well as criminal investigation record and traffic accident investigation data is mainly used. 4(6)

5 6. RESULTS The total number of deaths due to suicide in 2016 was 13,092, which was a decrease of 421(-3.1%) from The suicide rate (number of deaths per 100,000 population) was The number of deaths and mortality rate have continually decreased from The number of deaths classified X81 and X82 as underlying cause of death in 2016 was 25 and showed a decreasing trend from 2007(Figure 1). Figure 1: Trends in the number of deaths classified X81 and X82 from 2004 to 2016 base on cause of death statistics from Korean Most of the death classified as X81 and X82 in Korea is related to railway accidents. So, Korean government has installed screen door at subway platform from October In this reason, the number of deaths has continually decreased. Among the death classified as X81 and X82, 1 fatality died due to suicide in road traffic in 2016 and 2 fatalities in Statistics Korea could identify 2 deaths as suicide in road traffic among 32 in 2015 and 1 among 25 in 2016 through the automated mortality data system analyzing death certificate with administrative data of National Police Agency and National Forensic Service together. Table 2: Result of the suicide in road traffic in Korea Year Sex Age Place Detailed information Motive for a suicide 2015 F 52 Intersection The fatality jumped from the passenger seat and injured her head in collision with other vehicle. F 58 Street The fatality fell from the passenger seat and injured her head M 48 Farm road After addiction of cyanides, the fatality injured in collision with the parked vehicle. 2 years struggle against cancer Stress from rural life and depressive disorder Family trouble and debt problem The suicide in road traffic is not common in Korea comparing to other suicide methods. The deaths due to suicide in Korea tend to consider some points when they choose the method of suicide; least damage of a dead body; least pain; end up successful without sequela; no harm to others. In this sense, it is not easy to choose a traffic accident as a suicide method. Table 2: Comparison with suicide method 5(6)

6 Suicide method Hanging Fall Poisoning Burning Traffic accident Damage of a dead body L H L H H Pain M L M H H End up unsuccessful (with L L H H H sequelae) Harm to others L L L M H * L: Low, M: Moderate, H: high 7. CONCLUSION The study can conclude that there are few suicide in road traffic according to cause of death statistics in Korea. Such findings are evidence of the pattern to choose the method of suicide. However, in order to analysis more accurately, the definition of suicide in road traffic needs to be clarified. In some cases, it is hard to make a decision whether the suicide is in road traffic or not. For example, 2 fatalities died in 2016 due to fall from dam using motor vehicle. In these case, underlying cause of death could be classified intentional self-harm by drowning and submersion(x71). In addition to, ICD- 10 code need to add some extension code in order to classify a suicide in road traffic. To prevent suicide in road traffic, Statistics Korea will conduct continuously follow-up study. REFERENCES Statistics Korea. Annual report on the causes of death statistics [Internet]. Daejeon: Statistics Korea; 2015 [cited 2016 Feb 9]. Available from: World Health Organization. International Statistical Classification of Diseases and Related Health Problems 10th revision 2016 [Internet]. Geneva: World Health Organization; 2016 [cited 2016 Feb 9]. Available from: 6(6)